Provider Demographics
NPI:1649408584
Name:MADDEN, RACHEL N (DMD, MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:N
Last Name:MADDEN
Suffix:
Gender:F
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 SIMON ST
Mailing Address - Street 2:STE 11
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3046
Mailing Address - Country:US
Mailing Address - Phone:603-883-4008
Mailing Address - Fax:603-881-3822
Practice Address - Street 1:39 SIMON ST
Practice Address - Street 2:STE 11
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3046
Practice Address - Country:US
Practice Address - Phone:603-883-4008
Practice Address - Fax:603-881-3822
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1507421223S0112X
NH041451223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Single Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty